Ergonomics, image of the operating field, which is

also called human factors, is the scientific discipline concerned with the
understanding of interactions among humans and other elements of a system, and
the profession that applies theory, principles, data and methods to design to
optimize human well-being and overall system performance.


Ergonomics as a science is somewhat
new. This field has to do with machines and tools enhancing the performance of
the user. Ergonomic is applied today in industry, the
military, and sports training to help people achieve prime
performance with a low error and injury possibility. In the field of medicine,
ergonomics has been increasingly important and understood. Ergonomic
problems have been investigated in relation to intensive care units, back
injuries in health care workers, and job difficulty in medical-surgical staff

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Under open conditions
surgeons can view their work directly. The main visual ergonomic considerations
are the capability of the exposure of the operating field to direct viewing and
the quality and intensity of lighting on the field. Exposure is aided by proper
positioning of the patient and the application of mechanical retractors to the
wound and internal tissues. Importance of the proper lighting of the surgical
field still remains in the dark. For instance, uncertainties regarding the
optimum size, location, and number of surgical lights still remain a mystery.


With the introduction to video
endoscopic surgery, the surgeon views a relatively low-resolution monocular
video image of the operating field, which is somewhat usually ruined by lighting
inside the body cavities and by the movement of the camera-holding assistant. With
this, surgeons require longer times to complete tasks when compared with direct
binocular or direct monocular vision, contributing to significant performance limitations.
Therefore, we can point out that high technology is not always the right answer
for humans.


The position of the video
display in relationship to the doctor’s eyes is usually ignored in video
endoscopic surgery. Video monitors are placed on top of equipment carts or
wherever there is space in the operating room, with the consequence that the
image lies above the average surgeon’s eye level. The disproportionate
height has been linked to neck and back pain. One approach to improving the
position has been to install them on ceiling-mounted booms that can be
positioned as desired around the operating table.


Standard open surgical instruments surgery
such as forceps, clamps, and scissors evolved rapidly into standardized designs
that are easily and universality used. With mass production and rapid sterilization,
they are very efficient and handy. Surgeons have perfected the skilled and
efficient use of these instruments. The power of grip and the precision of grip
used by surgeons, the mechanics of passing instruments from the scrub nurse to
the surgeon, the suturing movements are of importance regarding these tools.

The internal mechanical design of video endoscopic surgery instruments
results in significantly diminished tactile feedback and an unfavorable
force transmission ratio from handle to tip. Laparoscopic instruments have
also been shown to have a nonlinear relationship between input and output
forces, which further degrades the surgeon’s ability to delicately sense tissue
characteristics. All
told, video endoscopic surgery instruments
have been shown to require 4 to 6 times more force than open surgery
instruments to complete the same task. With these less-effective instruments,
it is not surprising that surgeons report increased fatigue following video endoscopic surgery.